The Reasons for not Utilization of Intrauterine Device among Short Term Modern Contraceptive User Women in Hossana Town Public Health Facilities: Qualitative Study

Abstract

Background Intrauterine device (IUD) is a safe, long-acting, and effective method of contraception. However, is under-utilized in many countries, including Ethiopia. The several studies presented to address the problem, nearly all are quantitative. These have primarily generated a list of associated factors and reasons that did not seem to help health systems to design effective strategies to address the problem. This study looked at the problem with a different approach to explore the issue in detail and help to develop locally appropriate strategies to increase the utilization of IUD in the study area. To this end, qualitative method focused entirely on understanding why short term contraceptive user women are not using IUD from the maternal health service programs. Objective To explore the reasons for not utilization of IUD among short term modern contraceptive users in Hossana town public health facilities, southern Ethiopia. Method A Phenomenological qualitative study was conducted in Hossana town public health facilities, Southern Ethiopia from November 1-30, 2019. A total of 13 in-depth interviews were conducted: eleven short term contraceptive users, one health centre head and one health extension worker/community health worker/ were included in the study. Semi-structured interviewer guided questions and tape recorder were used to collect data. The collected data were expanded, labelled and ordered chronologically. Data were organized after subsequent detailed reading and analysis. Thematic analysis was used to analyze the collected data. Result In this study, the reasons for not utilization of IUD was poor knowledge about the benefits of IUD, insufficient counseling and not providing informed choices, and the absence of trained health personals and shortage of necessary supplies. Conclusion The main reasons for not utilization of IUD was poor counseling of mothers, unsupportive provider-client relationships, and poor counseling by service providers. Efforts to rise IUD users need to focus on improving counseling of mothers and strengthening the health systems.